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Murmur, mild leak in the mitral valve, what to do?

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I have an identical twin sister, in excellent. keeps her weight down, exercises 30 minutes a day, eats a healthy diet, no red meats, maybe once a month, doesn't smoke, her bloodwork is excellent, especially her cholesterol. LDL 99, HDL 82, Trigyserides 45, and everything esle is great. Se has been going to her doctor for the past 10 years, until he retired. She started to see another doctor, 2 weeks ago. He found a slight murmur, she had an EKG, which was good, doppler, good, and and echocardiogram which the finings were a mild leak in the mitral valve. She is a basket case right now and so am I, because we are very close. Her doctor said not to worry, but of course she is upset. why did her previous doctor never found it, and her new doctor found it. He said not to worry, and she'll take an echo every year, but she is freaking out, because she feels so good. No shortness of breath, never fatigue, no palpitations and she is very active. By the way we both get the white coat syndrome.


Category: Cardiologist

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Category: Cardiologist
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Thank you for asking your query.


From your description I understand that your sister has been recently found to have a slight murmur  caused by a leaky mitral valve. This probably is a condition called mitral regurgitation. And there is nothing to be overly worried about it ! The reason being, a leaky mitral valve is a common occurrence. Infact A trivial amount of MR (mitral regurgitation) is detectable with sensitive Doppler techniques in up to 70 percent of healthy adults; this is often termed "physiologic" mitral regurgitation. Another study called ‘Strong Heart Study’ showed moderate valve leak was found in 2 out of 100 normal people. 


The fact that she is does not have any kind of symptoms is a very positive sign. She has excellent Lipid profile, stays active and healthy. So I have the same thing to say as her Doctor said ‘not to worry’. The previous Doctor might have over looked it. This happens occasionally because of the above said reasons (common, not very harmful etc). Your Doctor has recommended the right thing for her. An yearly Echo and physical examination is the best way to monitor the progression, t. Other than the checkup there is no need for any other active intervention.


Wishing you the very best and Good health

Patient replied :

Thank you Dr. Deepak, for your answer.  I feel so much better with the answer you wrote to me, because I was stressing myself out.  As I wrote I am an identical twin with my sister, and we are extremely close. When she told me about the mitral valve leak, I became a basket case. I wonder if I have a slight murmur like my sister also, I will soon find out i 2 weeks when I go to see my doctor, in fact he is a new doctor also that I am going to see, because I used the same doctor as my sister previous, who had retired. I too have a very good cholesterol, like my sister.  I was wondering if I have the same as her,since we both have the same DNA, in fact we had it done a few weeks ago, and we got the results back today. And it was 99.99%/My sister' HDL is 82, LDL 99, & triglyserides 45.  Mine is HDL 77,LDL 113, and triglyserides is 55.  Her's is better than mine.



Thank you for asking the followup question.


The mitral valve leak is not hereditary. It is more of an acquired 'wear and tear' phenomenon. That's said, there is always some genetic component into any disease. And I am sure you both share some similar environmental factors too. So the bottom line is that you may have, you may not have it. Without a testing you cannot be sure about this. 


I somehow feel you are going to be clear. Just an assumption, I guess you will have to wait 2 weeks to be sure about it. The cholesterol levels and this mitral valve leak has no direct relationship. So the lipid values are not a factor in this. 


Hope this helps.

Patient replied :

Hi, doctor you mentioned that it is not heredity, mitral valve leak, you said it is wear and tear.  I didn't understand that.  Could it have been from stress.  Because my sister was always more stressed out than me.  The only thing I feel bad, that whydoes she have to have it and not me.



The valve has been functioning for 72 years for now ! So there can be wear and tear.

In a lighter note, among all the taps which bought in my house (same time, same model, same company) 1 is leaking, Why ? It happens over a period of time for any moving objects. There can be some reason behind why only 1 tap is having an issue. But its not easy to find it out precisely. Various factors might have influenced (and may be stress too !)


And once more I wan you to understand this valve leak is part of the normal aging process. There is no need for any concern. An yearly followup should do just fine.


Hope this helps

Thank you

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
Dr. Vivek Mahajan and 4 other Medical Specialists are ready to help you

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